My "birth plan" seems a bit crap.

[ChineapplePunk]

Basically, my birth plan consists of seeing how far I can get with gas and air and then opting for an epidural if I don't think I can make it. Can't really think of anything else I would like to include in regards to pain relief. I really do not fancy taking pethidine or any other opiates. From what I have read, it doesn't sound particularly beneficial for either baby or mother. Has anyone anything positive to say about it? Or any advice in regards to maybe coming up with a more comprehensive birth plan if this sounds a bit too basic? I usually feel that simplicity is best, but hey, having a baby may not be that simple and I am fully prepared for the fact that anything could happen (although I hope I'm one of the lucky ones.) :)

It's easy to poo poo birth plans as being the preserve of self-obsessed middle class mothers, but I had a very go-with-the-flow one and I ended up with a Kielland's forceps delivery which was very traumatic. I had no idea that these particular instruments were banned in 20+ countries and really quite dangerous on many levels and I will write on my birth plan that I do not want them to be used again, as they are never medically a necessity. Hospital thought it was "great" I had a vaginal birth vs a cs, nine months later I was still struggling to walk for any distance and have ongoing issues I won't go into here. I am thinking this birth through and will do quite a lot differently with the benefit of hindsight.

35 weeks and just written my birth plan with my doula. It's extremely pragmatic and the only things I have stated are:

Deny me food or drink at your own risk
No scalpels anywhere near me unless life or death situation
Do not cut cord until it stops pulsating

Pain relief is something I will tackle when I come to it. Have done my research but as I have never been in labour before I don't know if I will need gentle methods (g&a) or an epidural. I certainly don't want to be arguing against my own birth plan when in mortal agony...

I recently had DC4, and my birth plan was pretty much: "I'm extremely anxious as some of your colleagues before you have been horrid so please be nice to me, give me the baby as soon as possible, and no needles until after the placenta has passed". It went well, they sympathised with the first two parts and didn't like the last bit (history of retained placenta and PPH, having the injection just after the placenta passed rather than just after the birth actually worked really well for me as I ended up with no retention and far less blood loss than previous ones with the injection right away which is the standard procedure).

working if it helps first birth forceps and vacuum - 2nd and 3rd were fantastic 2nd water 3rd also water at home (by accident)

Some of these birth plans make it seem as if the medical staff are the enemy and out to make it a horrible experience for you! I found it much better to go without a plan, getting on friendly terms from the start.
I don't know how they go about their job if they keep having to refer to lots of notes -I would rather they got on with what they had to do than say 'hang on-I must read page 4'! You are there-they can talk to you!! If you have gone past the stage where they can talk to you there must be medical danger and does it matter?

Friendly terms has nothing to do with it. My SIL is a medic who worked in obs/gynae for many years and says really there are many decisions made according to pathways etc that are made as they are the most cost-effective andwhile safe etc are not always the best for the woman. I know this myself working in the NHS, the care is often basic for anyone perceived to be low-risk etc and this can lead to decisions which can have outcomes that are less positive for women. Watch One Born Every Minute to see a lot of women being continuously monitored lying on their back during delivery which is really not the best way to give birth. I had a late, large, malpositioned baby and I was drip-induced. The likelihood of natural non-instrumental delivery was never good, and the chance of perineal trauma was going to be higher with this course of action but this rocketed with use of high-cavity forceps. From a medical point of view, instrumental births are straightforward but women do regularly suffer trauma from the use of some instruments in particular and it is best to be educated yourself about how your own actions may impact upon what happens. If you let it all just wash over you and are "yes sir, no sir" about it, take the epidural at the first twinge etc, it is highly likely you will not be active in birth, will accept unnecessary monitoring that increases how stationary you are and will increase your chances of instrumental delivery/emcs. Being passive about your birth and allowing how it unfolds to be directed by others is an option for everyone but it is not the best one for everyone just because some people find this useful.

I'm a big fan of short & simple birth plans, OP. Don't see why it must be detailed.

Ours is a war and peace epic with all the T's crossed. I want to use a tens machine and want to try to avoid any drugs.

xx

I asked my MW if I really needed to do one with my 3rd as the previous two had been such different births there really seemed no point in planning anything.
So I kept it short.
As it turned out by the time I'd got a bed, mw went out to get paperwork, waters went bringing baby with them, one push & out she came. Didn't even really get to exchange names till after.

Mine was the same sockmonkey-there would never have been time to look at it when the birth consisted of 'can I push' and 'yes'.
How on earth do they remember when you take 'was and peace' with you?!
You have more chance if you stick to about 3 bullet points-certainly no more than 6.

I haven't had my baby yet and have written a couple of birth plans. 1st was homebirth plan, mainly leave me to get on with it unless something goes wrong then do what you need to but keep DP away from the business end. Now 11 days over and pretty sure this one isn't coming without some assistance so I have a 2nd for induction with a couple of notes (3rd) for CS delivery.

I don't have a clue how it's going to go, I'm not a midwife and I haven't had a baby before. I do know myself though. By writing a birth plan I feel that I have an understanding of what may happen, like being mentally prepared. So in that way it doesn't matter if they read it. It's all based around what is medically necessary though, the important thing is getting him out safely. It's written in many places across my notes to not give me opiate based pain relief even after a CS. It's not because I think I won't need it but because I won't know who I am for days if they do give me any. If MW's are trying to pull me off the walls during labour then I doubt there's going to be any benefit. My Dr supports that.

The only thing on mine was that I didn't want pethidine because I was terrified if it making me sick. DS was back to back and things were going soooooo slowly. They recommended syntocin to get things going and an epidural because of it. The hospital was full and there was going to be a really long wait for the epidural so I had pethidine in the meantime. It was awesome! Although I kept falling asleep during contractions and my dh had to hold me onto the birth ball I was bent over. Gutted when they wouldn't give me more!

I get a bit sick of the 'anti-incantation' people tbh.

What if you want 'all the drugs' but are refused them due to busy ward?
What if you get the drugs but none of them do anything?

Well, incantation, and your own internal resources are all you are left with I'm afraid. IMO it is stupid not to practice, rehearse and think about how you might access these resources should you need to.

What I hate most however, is the perpetuated idea that drugs, active birth, no lying on back, midwife support, birthing pools are a certainty.

They are not. Even in MLU they are not.

The Edgeware Birthing unit is responsible for 80% of the UK's waterbirths (including those at home). They have just 3 rooms.

But how many women go into labour believing that they could have one if they wanted?

My birth plans were along the lines of let nature do its thing unless we are dying, but I do remember having to threaten violence to get an epidural during the first and only hospital birth I had, as they were hopeless at being supportive.

The only thing I'd add in is what sort of vit K you want (oral or IM), and if all according to plan would you want synto for 3rd stage? And only becfause they're management/admin type things that you might not want to be worrying about for the first time on the day.

My section for "pain relief" is a one liner:

TENS: Gas and Air: Epidural (if labour is long and painful).

Couldn't think of anything else to write. DH already knows to massage my lower back where contractions start (that really helped me last time during first 2 hours of active labour).
My hospital don't administer pethidine readily - so I know they won't even suggest it to me.

I think your plan sounds fine to me. Just work your way through different methods until you find something that suits your level of pain. I ended up getting an epidural last time - best thing ever!! Good luck!

I wrote a 1-page 'plan' of bullet points that summarised my relevant history, and a couple points that were very important to me, like 'do not examine or touch me without my explicit consent - unless I cannot consent in which case talk to MrNC', 'as little monitoring as is sensible', 'happy to have students present and doing exams if under strict supervision, but should any cutting/stitches be necessary then I want an expert!'

and also 'am terrified of the idea of an epidural but as I can't take pethidine realise this may be the only option if g+a doesn't cut it', and a section of 'things I don't care about: who cuts the cord, music in theatre, how vitK is administered' etc.

Result - MWs told people coming into the room to read the 1-pager rather than my huge folder of notes, I didn't get scared by strange people touching me unexpectedly (I'm deaf and have bad startle reflexes), had only 2 VEs, and a lovely chap talked me through the epidural I had in the end which was excellent.

I'll be using roughly the same text this time, only with the addition of a postnatal section - I want to avoid a PN ward if at all sensible and get home with dd. Should we need to be admitted, actually getting some care at night would be nice unlike these things which happened last time (a,b,c,d...).
I did have 'please tell the Bounty woman to fuck off so I don't have to' but will omit due to lack of space and can't find a polite way to succinctly phrase it!

I think if a plan gives the staff info on your worries, fears, etc, then they can work with you a lot better.

I had a short version and a long one. Short version covered the essentials in case I arrived at 10cm. Long one was in case I was in hospital for longer or things didn't go to plan and would have given DH a steer. It was colour coded and everything.

That said I didn't 'need' my birth plan but writing it was helpful, discussing it with my MW even more so and being able to have DH say 'she's concentrating we wrote it all down' was worth its weight in gold.

It also meant that the interventions I would/wouldn't accept were discussed and signed off by my OB.

Essentially: I speak English, I will understand you but I may not be capable of replying, him over there will translate. I don't like hospitals. Touch me at your peril. Get that fecking needle away from me. Knock me out if you have to. If you do that then there must be someone to debrief with me the minute I come round because I don't deal with gaps in my memory well. DH stays with the baby if we are separated but take a photo of him with it to show me as proof that it wasn't a nightmare

Any plans for what you are going to do at home before you go to hospital?

I recommend getting luxury bubble bath to make you super relaxed and have a DVD ready so you can watch an enjoyable movie in between early contractions.

I think birth plans are important as they let the mw and dr know what kind of mother you are. Also even though my birth was the opposite to what I planned the birth plan was still relevant. You also need to let them know if you're doing anything "unusual" such as oral or no vitamin k rather than the injection, birthing the placenta naturally, etc.

Mine covered: pain relief, avoiding c section if possible, dh's role, vitamin k, that DH would stay in verbal and physical contact with DD if she needed to be separated from me fir any reason after the birth. It was less than half a side of a4 in bullet points and mw commented on how good it was.

Try to have a go with gas and air prior to the labour as I was shocked to find I hated it when I had been planning on relying on it.

After reading through all these posts I have decided that my birth plan will be thus:

'Wake me up when it's out.'

scared

My plan was very simple, in large capital letters:

"DO NOT TOUCH MY FEET!!!"

I couldnt give a foggy about anything else and very happy to go along with whatever i think/the HCP think at the time, but i am absolutly phobic about feet...my midwive took the plan to the nursing station so they could all have a laugh at it

They didnt touch my feet though :)